NHS savings may damage patient choice

28/07/2005

A shake up in NHS care outside of hospitals may hamper the drive towards patient choice, a leading think-tank fears.

Under new arrangements announced yesterday, district and school nurses, therapists and other frontline staff, currently employed through primary care trusts (PCTs), will be employed by charities, independent providers or other public bodies.

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PCTs are responsible for three-quarters of the NHS budget, using it to ensure enough hospital and GP services are provided in each region. Yesterday Sir Nigel Crisp, head of the NHS, demanded 15 per cent cuts in their administration and management costs, to save £250 million a year.

He made clear the cuts would mean far fewer PCTs - bodies that were phased in only five years ago - and a reduction in the 18 strategic health authorities.

Unions immediately warned of job cuts or changes in employment terms.

Think-tank The King's Fund expressed their fears, warning that the changes may derail reform geared to improving patient choice.

And with a quarter of all trusts already failing to balance their books, critics fear financial stability will be further strained.

The organisation of PCTs is expected to change by October next year and strategic bodies by April 2007. By 2008 the trusts will be expected to provide few direct services of their own.

Karen Jennings, head of health at Unison, told the Guardian: "These changes have profound implications and could lead to major disruption and instability for services such as cancer screening, family planning and occupational therapy."

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